Efficacy of low-dose amitriptyline for chronic low back pain

The results of a new study suggest that low-dose amitriptyline may be effective in treating chronic low back pain. Researchers from Australia and the Netherlands conducted a randomized clinical trial involving 146 adults with chronic, nonspecific, low back pain.

The results of a new study suggest that low-dose amitriptyline may be effective in treating chronic low back pain. Researchers from Australia and the Netherlands conducted a randomized clinical trial involving 146 adults with chronic, nonspecific, low back pain. Participants received low-dose amitriptyline (25 mg/d) or an active comparator (benztropine mesylate, 1 mg/d) for 6 months, with the primary outcome pain intensity measured at 3 and 6 months using the visual analog scale and Descriptor Differential Scale. According to the authors, "Although there were no significant differences in pain, disability, and work outcomes between the groups at 6 months, there was an improvement in disability at 3 months and minimal adverse events reported at 6 months for those treated with low-dose amitriptyline compared with the active comparator group." Nine participants from each group withdrew from the study due to adverse effects. The researchers note that large-scale trials of low-dose amitriptyline for the treatment of chronic low back pain are needed, adding that "in the meantime, it may be worth trying low-dose amitriptyline for these patients, especially if the only alternative is an opioid."